Bivalirudin Use in the Elderly for Acute Coronary Syndrome
Obiora Anusionwu *
Department of Cardiology, Drexel University College of Medicine, Philadelphia, USA
Raef Madanieh
Department of Internal Medicine, Morristown Medical Center - Atlantic Health System, Morristown, New Jersey, USA
Gary Ledley
Department of Cardiology, Drexel University College of Medicine, Philadelphia, USA
*Author to whom correspondence should be addressed.
Abstract
Introduction: Bivalirudin has been approved for use in acute coronary syndromes as part of the anticoagulation regimen. Elderly patients are at a higher risk for bleeding because of their co morbidities, decreased body mass and their age. Hence, this article reviews the landmark published papers on bivalirudin therapy in this patient population with the goal of understanding the particular benefits and risks.
Discussion: Several review articles suggest that the use of bivalirudin alone is associated with lower rates of major bleeding when compared with unfractionated heparin plus glycoprotein IIb/IIIa inhibitor in patients with acute coronary syndrome with invasive strategy planned. These beneficial effects span through the age ranges. Therefore, it is a good option for elderly patients. Decreased bleeding complications lead to better clinical outcomes in the elderly after percutaneous coronary intervention. It also leads to decreased length of stay in the hospital.
Keywords: Anticoagulants, elderly, acute coronary syndrome, ST elevation myocardial infarction